This topic is about the challenges faced by someone with a colostomy, particularly dealing with a problem known as "pancaking." Pancaking happens when stool collects around the stoma instead of sliding down to the bottom of the pouch, often due to the vacuum created by filters in the pouch. Here are some insights and advice shared by others who have faced similar issues:

1. The person experiencing these issues has found that filters in pouches can create a vacuum, causing stool to spread under the wafer instead of dropping away. They have tried blocking the filter with a sticker during the day and removing it at night, or letting air in through the tail after emptying.

2. Frequent leaks require changing the pouch every 2-3 days to protect the skin. Despite trying many samples from different companies, finding a lasting solution has been difficult. Even keeping the effluent off the convex part of the base for two days is considered a success.

3. The trial-and-error process is exhausting and can be disheartening.

4. A convex one-piece sample with a soft plate and strong adhesive was tried but removed after 24 hours due to leakage and skin irritation, possibly due to an allergy.

5. Currently using a one-piece Hollister sample but still dealing with odor issues. They have a large collection of samples from various products.

6. An excellent ostomy nurse visits twice a week, sending photos to manufacturers for tailored samples.

7. The current routine involves using a Hollister barrier-remover wipe, washing with warm water, thoroughly drying, and then applying the appliance. Powder or barrier film is used only when the skin is irritated. Appliances stay on, but leakage starts at the stoma due to its irregular shape.

8. Seven surgeries in 18 months have led to overwhelming fatigue.

9. They have not yet tried using a barrier ring and paste together and are unsure where to start.

10. They have asked others for specific pouch numbers that work without filters.

Advice and insights from others include:

- Venting options: Consider installing an Osto-EZ Vent on any pouch to manually release gas instead of relying on built-in filters. If the pouch has a filter, cover it with a sticker or tape and "burp" the pouch as needed.

- Irrigation for colostomates: Some suggest trying colostomy irrigation, which can eliminate daily pouch wear and filter/pancaking issues when successful.

- Diet matters: Adjusting diet can help reduce pancaking by influencing output consistency and gas amount.

- Equipment that provides long wear time for some users: The Coloplast SenSura Mio 2-piece system and certain Hollister one-piece pouches have been effective for some, allowing for longer wear times without leaks.

- Barrier strategies: Combining a moldable barrier ring with stoma paste can help fill uneven skin surfaces and improve seals on difficult stomas.

- Understanding "pancaking": This issue is often linked to excess suction or lack of air, causing stool to collect around the stoma instead of moving to the bottom of the pouch.